Active NPI
City of Lake Crystal
Doing business as Lake Crystal Ambulance Service
- Land Ambulance
- Lake Crystal, MN
National Provider Identifier
1679584205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 0127
- Legal business name
- CITY OF LAKE CRYSTAL
- Doing business as
- Lake Crystal Ambulance Service
- Practice address
- 181 S Hunt Street
Lake Crystal, MN 56055-0086 - Phone
- (507) 726-2538
- Fax
- (507) 726-2265
- NPI assigned
- Aug 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rhonda Truman-Ingebritson
- Title
- Ambulance Director
- Phone
- (507) 995-6205
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 0127 | MN | Primary |
Addresses
Primary practice location
181 S Hunt Street
Lake Crystal, MN 56055-0086
Mailing address
100 East Robinson Street
P.O. Box 86
Lake Crystal, MN 56055-0086
Phone (507) 726-2538
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590095208 | Other | RAILROAD MEDICARE | |
| 181767100 | Medicaid | MN |
Other names 1
- Lake Crystal Ambulance Service
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120213000068 | MN | Part B Supplier - Ambulance Service Supplier | 5092972588 | Practice locations: Lake Crystal, MN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0959632 | Lake Crystal Ambulance | Certificate of waiver | Apr 14, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750204800000",
"number": "1679584205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 EAST ROBINSON STREET",
"address_2": "P.O. BOX 86",
"city": "LAKE CRYSTAL",
"state": "MN",
"postal_code": "560550086",
"telephone_number": "507-726-2538",
"fax_number": "507-726-2265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 S HUNT STREET",
"city": "LAKE CRYSTAL",
"state": "MN",
"postal_code": "560550086",
"telephone_number": "507-726-2538",
"fax_number": "507-726-2265"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF LAKE CRYSTAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-10",
"last_updated": "2025-06-18",
"certification_date": "2025-06-18",
"status": "A",
"authorized_official_last_name": "TRUMAN-INGEBRITSON",
"authorized_official_first_name": "RHONDA",
"authorized_official_title_or_position": "AMBULANCE DIRECTOR",
"authorized_official_telephone_number": "507-995-6205"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "MN",
"license": "0127",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "590095208",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "181767100",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lake Crystal Ambulance Service",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lake Crystal, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.